Saturday, October 31, 2009

Surgery Rotation - End of Week 4

Surgery rotation is going well. We are being involved and learning things.

I'm glad that I already have skills like cannulation and phlebotomy under my belt from earlier in the year, as it is one less thing to be concerned about learning.

We are also at a slightly smaller hospital, so we get to scrub in and assist the registrar from time to time. I can actually enjoy a little bit of scrubbing in and assisting. After a while it wears thin, but I think I'll be alright with a bit of it in the next few weeks, and then maybe again when I'm an intern and need to help out.

There is nothing much new to add. I'm still trying to learn a lot (well, enough to get through) and work hard, because we have a lot to do during the week.

Today I helped out in preparing some second years for their MSAT exams (Multi-Station Assessment Task) and took part in a mock exam. It was quite fun and it really sank in just how far we have all come in the space of a year.

The students weren't bad (a few of them were lacking in confidence) but you can see that they REALLY need personal attention and teaching from people who actually know what they are doing. It is one thing to learn a technique from a list on a piece of paper, and another to actually see that technique demonstrated by an expert.

This is just the way medical school works. You spend the first two years learning the theory behind things, and then you get to see it in action and try to understand how it REALLY works in the following two years.

I always think that it is unfair when people expect you to know something that you haven't actually been taught, specifically when these things are practical skills that you can only learn when somebody who knows what they are doing passes these skills on.

One of the problems with the massive increase in class size in medical schools in this country is that we aren't getting the personal attention that we could have received in previous years. It just isn't logistically possible.

This isn't so bad when it is in the first couple of years of medical school, but the potential for there to be so many interns, residents and registrars that we don't get proper teaching is there and it is a horrifying thought.

My fingers are firmly crossed that it doesn't come to that, but you can't have a huge leap in graduate numbers in such a short space of time without the system failing at some point. I still think I'm ahead of the biggest increase in the next couple of years. Fingers crossed.

Friday, October 30, 2009

Yet more medical school bitterness

Assignments - I never do well on the ones that I expect to, and I somehow ace the ones that I wonder are going to be good enough.

I can never tell which ones will be which.

I got two results back this week. One was for an assignment that I did a lot of work for on the main project itself, but did the write-up very quickly and wondered afterwards if it should have been more "academic".

The other was for a group assignment that I did, where we all put in a fair bit of work together. As group assignments go, you all put in work into the one thing and hope your side of the work doesn't let everybody else down.

I aced the first one and got a mediocre mark for the second. Funnily enough, I would prefer it to be the other way around, because I'm dissapointed for the group. I know how we all worked on this one.

I guess passing is the main thing.

Friday, October 23, 2009

Surgery Rotation, End of Week 3

We have just finished our first week of general surgery, and I'm exhausted.

It is much more interesting than orthopaedics for me, mainly because there are so many medical issues involved with the patients. I'm not overly keen to scrub in, mainly because I don't find the process of surgery very interesting, and I would rather be free to wander the room (not to mention gossip with the nurses/anaesthetist/techs - maybe this is why I have never had a problem with theatre staff ;) ) rather than be tied to the sterile area with my hands tucked away or on the patient.

We have been doing longer hours than we were in orthopaedics, and even though we don't have a lot of responsibility, we can help out and run around and see a lot of things. There are also tutorials to prepare for and present, and assignments to write. Overall it is a pretty busy rotation.

I have also been cutting back on the amount that I'm eating. I'm trying to find the happy medium where I'm eating enough, but still eating less. I have lost quite a bit of the weight that I have put on since starting medicine over the past few months, and that has accelerated in the past two weeks since reading French Women Don't Get Fat.

It is amazing how many extra calories you can fit in by eating everything on your plate even after you are full, and by snacking in between meals. When you stop those things (if you do them), the weight just starts to come off by itself. You can still indulge in a little bit of everything, just in moderation. I'll always be a three-meals-a-day girl, and I'm addicted to breakfast.

Sadly, cutting down on calories and being in deficit also makes you a little bit more tired. Oh well. At least my pants fit better now. I am a happier person being a little tired rather than walking around in a skirt/pair of pants that are a little too tight.

Another strange thing has been happening to me all this week. I keep running into people I have worked with before in my former professional life, some of them for more than two years, and they don't recognise me at a glance as they walk by. It is really off-putting. I suspect it is the fact that I am in professional clothing rather than a uniform or scrubs. When it happens once, twice or even three times it isn't so bad. But when it happens continuously with just about every other person you worked with over the last two years of your working life - well, that is off-putting.

They recognise me when I stop them to say hello, which is nice. (I only do this when we are stopped for coffee or not going in opposite directions down a main corridor. I'm not that anxious for recognition!) Perhaps I just pay more attention to the people walking by me. It could also be that I'm excited to be back in the hospital I used to work in, so it is more than just another work day for me. It is nice to see them around.

Tuesday, October 20, 2009

Surgery Rotation, Week 3

Surgery is okay. I don't love it, but I find it interesting.

I wonder if this is how the people with whom I did my psych rotation felt about psychiatry?

We did our rotation at a hospital where they have good teaching for psychiatry, so a lot of the students enjoyed it, even though it isn't what they want to do.

I quite like the practical aspects of surgery. My brain works fairly well that way, too. I am just not a surgical person, if that makes sense. I want to be the one in the room talking to them about their depression because they have had chronic physical illness, not the one treating the illness with surgery.

Still, I'm enjoying the reading. I am also really enjoying the specifics. I like zeroing in on an area and concentrating on it. I'm not much of a lover of the general nature of GP or rural rotation. I can understand how other people would enjoy it, but it isn't for me.

I think I would be keener if it weren't so late in the year and I didn't feel so completely exhausted. Rural took it out of me even more, and I have noticed the exact same thing in the others around me.

Bleh. Almost there. I'm just grateful that I get a break at the end of the year. I'm going to enjoy it while it lasts.

Tuesday, October 13, 2009

Things I'm looking forward to #1

I was thinking this morning about the things that I am looking forward to when I graduate and become a paid doctor.

One of them is definitely going to be attending conferences.

For some reason, I have never really been to a proper conference before. I could have gone in my past profession, but I already knew that I wanted something else, so spending money traveling and attending these as well as taking leave was not something I wanted to do. There was also the issue that for the first couple of years I was working, I was quite junior on staff in a department that preferred letting their more senior staff attend.

I got to go to weekend educational sessions, which I always enjoyed.

As a medical student, we have had the AMSA conference every year, but to be blunt, this seems to be more of a massive week-long party than a genuine educational event, and I could never make it a priority. I am older, in an established relationship, and am an introvert, so the AMSA conference seems like my idea of a nightmare.

Next year the AMSA conference is going to be in Hobart. I'm seriously thinking of going down to Hobart the week before, for the Global Health Conference. I have relatives in Hobart who I could stay with for a week who live in the centre of town. It would be nice to get away and attend this. It also doesn't cost the earth, which has been another prohibitive factor in potentially attending these things as a student.

It is something worth thinking about.

I am also wanting to attend at least one conference in my intern year. I'll just have to find one to attend before I put in my leave preferences for intern year so that they hopefully match up.

What is it about conferences that I'm looking forward to? I'm not sure. Things are so shiny and well-presented most of the time. You get to spend your whole day focusing on areas that you are interested in. If you are lucky and they haven't changed the laws yet, there may be freebies from sponsors.

I'll have to see what it is really like when I get there in 2011.

Thursday, October 8, 2009


I thought I should add that I was asked not once, but twice the other day what I was going to become after saying that I was a medical student.

After telling him what I was studying, a security guard asked me if I was a nurse and which ward I worked in. I said, "No, I'm a medical student, and I'm on the surgical team." He looked confused and ticked the "nurse" box. It was for a survey that I had to take before being allowed to get into work via a certain entrance, so I couldn't be bothered correcting him - his head may have exploded with the insanity of this topsy-turvy world where they allow females of child-bearing age to attend university and get an ed-u-cay-shun.

I was talking to a patient, and she asked me what I was a student of. I explained that I was a medical student, and am studying medicine. She asked me whether I was going to become a pharmacist or something else. I explained that I was going to become a doctor, and she was okay with that. I think in her case it was probably just a misunderstanding of the education process.

In the past I have been asked many times whether I am going to become a nurse after I have said that I'm a medical student. Now I just explain pleasantly that I'm going to become a doctor, sigh on the inside and move on.

I don't look young. (I'm no longer in my early twenties.) I dress professionally. I wear an ID. Perhaps I should wear a stethoscope more often, but something tells me that this isn't as awesome as you might expect.

MSILF is right - the revolution is far from over.

Surgery Rotation, Week 1

Surgery has been interesting so far. I know it isn't for me, but I like the theory and reading about the pathologies. I have decided that surgery is really quite revolting. I'm talking about the object of surgery (blood, guts and other random body bits), not the actual surgeons or surgical process, although the process can be quite . . . disturbing. They do things to the human body that go against all of my instincts.

This says a lot about me, too - I am intuitive and empathetic, so watching orthopaedic surgery really goes against my grain. I don't feel sick, have seen a lot of it before in my previous life, but it just feels really wrong. I have been told that I am quiet and reserved (usually by pushy people who I don't like, so who knows if it applies elsewhere), and I don't run around the place hugging patients and wanting to be their friend, but I also don't like causing them pain. On an intellectual level, I know it is helping them, but on a gut-level, my inner voices says no.

I'm glad they don't show patients what a joint replacement looks like before they get one done. If I ever have to counsel a patient who is going to get a joint replacement, I would strongly advise against looking it up on You-tube, or there other video-sharing sites. If you hadn't seen much surgery before, and were watching a procedure that you were about to have done on your own body, it would terrify you!

The results are fantastic (when all goes well), and I am lucky enough to have seen this and spoken to the people who have had joint replacements change their lives and give them access to activities that they hadn't been able to do for years. It often goes so well with one joint that they leap in and get the opposite side done soon afterwards. It works, and is a great way to give people back their mobility. The actual process of performing the surgery isn't for everybody, and it isn't for me.

Psych is still at the top of my list of specialties I want to do. I try to attack the plan as critically as possible, because I don't want to leap in and then decide that it isn't for me, but at the end of mixing it all up, psychiatry still lands on top.

I have some nice friends who bear the brunt of this, and I hope they don't think I am too flippant or chaotic. Sometimes I worry a little that I do a big anxiety dump on them, and that is what it is - a huge vent. Hopefully they won't get sick of being a sympathetic ear. Sharing the load helps.

I really enjoy the content of psychiatry, I love talking to patients about their life experiences and what they are going through, and then analysing this and putting it all together in one huge concept of cause-and-effect and results that are open to change at any moment. I just kind of assumed that most people felt this way, but they don't. That is okay - it is a varied and interesting world, with room for surgeons and shrinks!

Sunday, October 4, 2009

A new page

My brother and his fiancee have set a rough date for their wedding. They will be tying the knot in twelve months time. I'm excited by this, because they have been together forever (roughly eight years), it means to much to them, and because it means the prospect of more nieces/nephews in the very near future!

I love small children, but I also love giving them back at the end of the day. I'm looking forward to having kids myself, but am in no rush to do so. I like children when they get to the age at which you can reason with them, talk to them, and have more fun. Cooing over very little babies is lovely, but I find it much more rewarding to interact with them when they can communicate back.

Having the wedding in twelve months time also gives me a great motivator to get back into shape. I exercised every day for months prior to my wedding, ending up with really toned arms and good level of fitness. I want to use this to get the impetus to get back into really good shape and exercise very regularly.

I know that I have surgery rotation next, and it could be time-consuming, but I think that it is very important to make exercise a central part of my life, much like sleep and food, and I'm taking this opportunity to get back into shape.

The sad fact is that it is now nearly eight years since I got married, so it may take me a little more time, but that is okay - I'm in this for life. :)

Friday, October 2, 2009

The End of All Things Holidays!

I had an "interesting" week off. We had a huge assignment to do, so I spent a fair bit of time either thinking about, doing or avoiding that. They give us "holidays" in this course, but fill them up with things that we are supposed to do while taking time off.

I can't wait for real work, when you get to spend your breaks travelling and getting away, as opposed to doing assignments, studying (depending on where you are in training of course) or working a paying job so that you can afford to continue to study.

I also spent quite a bit of time cooking and re-acquainting myself with my house and cats. This was quite lovely. It is incredible how quickly you get used to living differently and so when you arrive home with fresh eyes, things seem strange and exciting.

I have also changed a number of things about our house this week (minor organisational details), cleaned out some cupboards (spices from 2003 probably don't taste very nice) and relaxed.

Not having been to the gym for a couple of months, I went back again this morning. I did a Pump class, which is a group weights session with a high number of repeats and low weights. I haven't done it in a while and so I was SORE afterwards, and no doubt will be quite sore tomorrow! I also remembered just how much of a challenge it is to wash your hair when you don't feel up to lifting your arms above your head.

Things are getting back to normal, and it is just lovely. All that remains is for The Man to get back from working far, far away, and I will be happier.